Functional impairment in people with schizophrenia: focus on employability and eligibility for disability compensation.
Functional impairment in people with schizophrenia: focus on employability and eligibility for disability compensation.
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DOI：
10.1016/j.schres.2012.03.025
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发表时间：
2012-09
影响因子：
4.5
通讯作者：
Schoenbaum, Michael
中科院分区：
文献类型：
--
作者：
Harvey, Philip D.;Heaton, Robert K.;Carpenter, William T., Jr.;Green, Michael F.;Gold, James M.;Schoenbaum, Michael
关键词：
社会保障管理局（SSA）正在考虑精神分裂症是否有必要纳入他们新的“Compensation Allowance”程序，该程序旨在确定总是符合社会保障残疾福利的疾病和其他医疗条件，并且只需要最低限度的客观医疗信息。本文总结了精神分裂症与职业残疾之间经验关联的证据。一个配套文件检查精神分裂症诊断的可靠性和有效性，这是至关重要的相关授予长期残疾的基础上，目前的诊断。这是一个选择性的文献综述和综合，在由国家精神卫生研究所和SSA召开的专家会议上制定的工作计划的基础上。这次残疾流行率审查的重点是社会保障部目前采用的接受精神病残疾赔偿的标准。几乎每个精神分裂症患者都有多个功能领域的残疾。临床缓解比功能恢复更常见，但即使坚持治疗，大多数患者也会偶尔复发，缓解并不能预测功能恢复。根据SSA当前的残疾确定流程，SSA“精神分裂症/偏执性功能障碍”诊断类别中约80%的SSDI/SSI申请被允许，而总体上约有一半的SSDI/SSI申请被允许。此外，精神分裂症申请人的津贴额更高。许多申请不成功的人并没有被拒绝，只是在最初被拒绝后无法管理上诉程序。研究证据表明，被有效诊断为精神分裂症的残疾申请人在多个方面的功能都有明显的损害，并且通常在正常工作年龄期间或在开发新的干预措施之前都会受到损害。
The Social Security Administration (SSA) is considering whether schizophrenia may warrant inclusion in their new “Compassionate Allowance” process, which aims to identify diseases and other medical conditions that invariably quality for Social Security disability benefits and require no more than minimal objective medical information. This paper summarizes evidence on the empirical association between schizophrenia and vocational disability. A companion paper examines the reliability and validity of schizophrenia diagnosis which is critically relevant for granting a long-term disability on the basis of current diagnosis. This is a selective literature review and synthesis, based on a work plan developed in a meeting of experts convened by the National Institute of Mental Health and the SSA. This review of the prevalence of disability is focused on the criteria for receipt of disability compensation for psychotic disorders currently employed by the SSA. Disability in multiple functional domains is detected in nearly every person with schizophrenia. Clinical remission is much more common than functional recovery, but most patients experience occasional relapses even with treatment adherence, and remissions do not predict functional recovery. Under SSA’s current disability determination process, approximately 80% of SSDI/SSI applications in SSA’s diagnostic category of “Schizophrenia/Paranoid Functional Disorders” are allowed, compared to around half of SSDI/SSI applications overall. Moreover, the allowance rate is even higher among applicants with schizophrenia. Many unsuccessful applicants are not denied, but rather simply are unable to manage the process of appeal after initial denials. Research evidence suggests that disability applicants with a valid diagnosis of schizophrenia have significant impairment across multiple dimensions of functioning, and will typically remain impaired for the duration of normal working ages or until new interventions are developed.
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DOI：
10.1176/appi.ajp.2009.09010106
发表时间：
2009-07
期刊：
The American journal of psychiatry
影响因子：
--
作者：
Harvey PD;Helldin L;Bowie CR;Heaton RK;Olsson AK;Hjärthag F;Norlander T;Patterson TL
通讯作者：
Patterson TL
影响因子：
4.5
作者：
Harvey, PD;Jacobsen, H;Davis, KL
通讯作者：
Davis, KL
影响因子：
3.8
作者：
Bush, Philip W.;Drake, Robert E.;Haslett, William R.
通讯作者：
Haslett, William R.
影响因子：
17.7
作者：
Gold, JM;Goldberg, RW;Lehman, AF
通讯作者：
Lehman, AF
影响因子：
--
作者：
Druss, BG;Bradford, WD;Krumholz, HM
通讯作者：
Krumholz, HM